BALTIMORE – The movie magic that allowed Gollum to lurch across the screen in the Lord of the Rings films or capture the great ape’s naturalistic movements in the remake of King Kong is now being used in operating room research and training.
This special technology used by animators to record movement is just one of the high-tech advances being used at the new Maryland Simulation Training and Innovation Center that was due to open Dec. 7 at the University of Maryland Medical Center.
The multi-million dollar facility includes life-like patient simulators and computer-generated 3-D images to allow students to practice before they graduate to the operating room.
“That’s the key – in a simulation you’re allowed to make mistakes,” said Dr. Thomas E. Grissom, a United States Air Force colonel and director of the Baltimore Center for Sustainment of Trauma and Readiness Skills, C-STAR, an Air Force medical training program that contributed to the new center.
The center is a product of the collaboration of a variety of experts – computer scientists, electrical and biomechanical engineers, artificial intelligence experts, cognitive psychologists and medical personnel from the U.S. military – who all helped to create a new state-of-the-art facility where surgical residents can hone their skills and researchers can tackle critical challenges.
The motion-capture technology used in the center is so new that is has never before been used in a medical setting; was created for the center by the Lord of the Rings team.
A goateed man dressed in blue medical scrubs and white running shoes stands in the center of one of the new simulation rooms.
He wears “retro-reflective” markers, small spheres about the size of marbles, stuck to his chest, waist, wrist, knees, ankles and the black sweatband around his head.
The movement of these markers is recorded by 12 cameras mounted around the room’s ceiling.
As the suited-up demonstrator does a jaunty soft-shoe to show off the technology’s capabilities, a red and green stick figure mimics his dance on a computer screen about six feet away.
Being able to capture these large-scale movements as well as the subtle hand motions of a surgeon during an operation may be the key to improving surgical ergonomics and designing a better operating space.
During a minimally invasive surgery, doctors may suffer from the effects of having to hold tiny surgical instruments in awkward positions for many hours and straining their necks to see video feed from scopes inside the patient’s body.
By recording how expert surgeons move during simulated surgeries, researchers hope to design an operating room that reduces the physical ill-effects on the surgeon like shoulder and neck pain and carpel tunnel syndrome.
“You can have your golf swing measured, you can have your [baseball] pitch measured…but no one has even had surgical movements measured before,” says Dr. Adrian E. Park, the director of the Maryland Simulation Training and Innovation Center.
In the next room over, under a camouflage-covered ceiling, an unusual practice dummy lies on a stretcher wearing a neck brace and stripped from the waist up, his military-issue pants and right boot placed by his feet.
He is affectionately referred to as “Stan,” short for “the standard man” and military medical personnel use Stan to practice war-time emergency medical resuscitation.
Stan does everything a real patient would if wounded on the battlefield – he can be measured for heart rate, blood pressure and even papillary response.
At $250,000 used, Stan may be the world’s “most expensive Ken doll,” jokes Grissom.
The simulated skin on Stan’s chest stretches as he inhales and his eyelids flick up and down in an eerie approximation of blinking.
Grissom says that sixty percent of those who practice on Stan are deployed to Iraq or Afghanistan within three months.
“Simulation allows us to provide those uncommon instances that would be encountered in the field,” says Grissom.
Located on the seventh floor of the University of Maryland Medical Center, the new surgical simulation center is one of only a few such technologically-equipped hospital training centers of its kind.
“Students or residents can practice their surgical skills without putting any patients at risk,” says Dr. Stephen T. Bartlett, Chief of Surgery at the University of Maryland Medical Center, as he describes the center’s role in “important new developments in surgical safety.” “It’s the first of its kind in the US,” says Bartlett.